Presentation
Misattribution of the presenting complaints to a cardiac or other life-threatening disorder was reported in 20 patients (87%) and was the main reason for their presentation to the hospital. [ncbi.nlm.nih.gov]
Patients with chronic HVS present with similar symptoms, including recurrent chest pain, dyspnea, and neurologic deficits, and usually have had many similar presentations in the past. [emedicine.medscape.com]
All patients presenting to the ED with the primary diagnosis of primary hyperventilation during the study period were eligible for study inclusion. [journals.plos.org]
This patient's presentation is MOST consistent with: A)acute pulmonary edema. B)right-sided heart failure. CORRECT C)acute pulmonary embolism. D)spontaneous pneumothorax. [quizlet.com]
The final chapter presents clinical cases to illuminate useful strategies for exercise testing and interpretation. Useful appendices offer laboratory forms, algorithms and calculations, as well as answers to FAQs. [books.google.com]
Entire Body System
- Weakness
Hypokalemia tends to be less pronounced than hypocalcemia but can produce generalized weakness. Acute secondary hypophosphatemia is common and may contribute to paresthesias and generalized weakness. [emedicine.medscape.com]
Dizziness, confusion, unexplained fatigue, weakness ( these are common presentations because low CO2 reduces blood flow to the brain). [breathingwise.blogspot.com]
Weakness. Tinnitus. Palpitations. Feeling of choking or suffocation. Wheezing. Sweating. Loss of consciousness (uncommon). [patient.info]
Muscle twitching, spasms, and weakness may be noted. Seizures, irregular heart beats, and tetany (muscle spasms so severe that the muscle locks in a rigid position) can result from severe respiratory alkalosis. [medical-dictionary.thefreedictionary.com]
Excessive breathing can cause dizziness, lightheadedness, weakness, shortness of breath, a sense of unsteadiness, muscle spasms in the hands and feet, and a tingling feeling around the mouth and fingertips. [medicinenet.com]
- Falling
ETCO 2 is normal at rest and during exercise before falling below the normal range during recovery. The red line indicates the lower limit of ETCO 2. [breathe.ersjournals.com]
In hyperventilation, the amount of carbon dioxide in your blood fall. Low carbon dioxide causes chemical changes in your nervous system. This results in unnatural feelings and you may feel ill even when you are not. [tanvirreza.com]
The hyperventilation is self-promulgating as rapid breathing causes carbon dioxide levels to fall below healthy levels, and respiratory alkalosis (high blood pH ) develops. [en.wikipedia.org]
Even slight falls or fluctuations in carbon dioxide levels will directly effect nerve cells, as well as blood flow to the heart and brain, producing a wide variety of symptoms in any organ or system in the body. [familydoctor.co.nz]
However, dead space probably does not fall in asthma although it does fail to increase normally with inspiration. 26 Neither group were hypoxic and this cannot provide an explanation. [thorax.bmj.com]
- Fatigue
Chronic HVS does not have a number of obvious signs and symptoms yet it frequently leads to or propagates a number of conditions - often those typically thought of as conditions the person must simply live with such as Chronic Fatigue Syndrome, Anxiety [ndhealthfacts.org]
During World War I, similar symptoms often associated with fatigue were also attributed to cardiovascular dysfunction and described as "soldier's heart" ( Lewis 1919 ) or "neurocirculatory asthenia" ( Levine 1965 ). [medlink.com]
There is only one cause: low body oxygenation, poor blood circulation, fatigue, and hunger are all caused by heavy breathing. [normalbreathing.com]
Dizziness, confusion, unexplained fatigue, weakness ( these are common presentations because low CO2 reduces blood flow to the brain). [breathingwise.blogspot.com]
Facing and fighting fatigue: a practical approach. New Haven, Conn: Yale University Press. p. 40. ISBN 978-0-300-07401-7. ^ van Dixhoorn J, Duivenvoorden HJ (1985). [en.wikipedia.org]
- Sepsis
Sepsis Sepsis (blood poisoning) is a potentially deadly infection with signs and symptoms that include elevated heart rate, low or high... Shock (Medical) Medical shock is a life-threatening medical condition. [medicinenet.com]
Diagnosis The diagnosis is based on the presence of respiratory distress accompanied by low levels of oxygen in the blood and the presence of known risk factors such as sepsis, pneumonia, or trauma. [rarediseases.org]
Another typical combination is DKA, dehydration, and hyperventilation from pneumonia or sepsis. 16. Traditionally, inhalational anesthetics hyperventilation, opioids, and muscle relaxants are used in anesthesia for repair surgery. 17. [sentencedict.com]
Anxiety-hyperventilation syndrome (psychogenic) Other 'supra-tentorial' causes (pain, fear, stress, voluntary) Various drugs (eg analeptics, propanidid, salicylate intoxication) Various endogenous compounds (eg progesterone during pregnancy, cytokines during sepsis [anaesthesiamcq.com]
Patients can be induced to hyperventilate by the procedure of breath sampling itself [ 17 ]; furthermore, acute ventilatory changes are not infrequent in asthma exacerbations, sepsis, or during assisted mechanical ventilation. [bmcpulmmed.biomedcentral.com]
- Swelling
Causes of Intracranial Hypertension • Traumatic brain injury • Brain tumor • Subarachnoid hemorrhage • Brain swelling from cerebral infarction • Intracerebral hematoma • Extracerebral hematoma • Acute hydrocephalus • Cerebral venous thrombosis • Anoxic-ischemic [slideshare.net]
A 30-year-old male presents with acute shortness of breath, widespread hives, and facial swelling. He denies any past medical history and takes no medications. During your assessment, you hear wheezing over all lung fields. [quizlet.com]
Pulmonary Edema Pulmonary edema (swelling or fluid in the lungs) can either be caused by cardiogenic causes (congestive heart failure, heart... [medicinenet.com]
Tumors or swelling in the brain or nervous system can also cause this type of respiration. [medical-dictionary.thefreedictionary.com]
[…] charge of the human body - While inflammation response can appear due to a lack of electrical grounding of the human body, chronic inflammation is often caused by reduced circulation and low level of oxygen in cells due to chronic hyperventilation - Swelling [normalbreathing.com]
Respiratoric
- Yawning
Yawning: - Excessive yawning and how to stop yawning a lot: Causes and a simple breathing exercise that stop constant yawning in nearly 1 minute. [normalbreathing.com]
Frequent yawning and sighing as mentioned above. Air 'hunger' and feeling like you cannot take a deep breath or 'get your breath'. Poor exercise tolerance. [breathingwise.blogspot.com]
It may be caused by breathing faster than normal (more than 15 breaths a minute) mouth breathing, sighing or yawning frequently. [familydoctor.co.nz]
But signs may include: Shortness of breath, or feeling that you can’t get enough air A faster than normal heartbeat Feeling faint, dizzy, or lightheaded Pain or tightness in your chest Frequent yawn or sighs A numb, tingly feeling in your hands or feet [webmd.com]
[…] treatment for hyperventilation when the following symptoms occur: rapid, deep breathing for the first time hyperventilation that gets worse, even after trying home care options pain fever bleeding feeling anxious, nervous, or tense frequent sighing or yawning [healthline.com]
- Tachypnea
The symptoms of acute hyperventilation are mainly caused by the hypocalcemia. 4 Symptoms Tachypnea Muscle spasms Paresthesia Dizziness Anxiety Spasms of the muscles of the lower arm and hands ( hyperventilation tetany ) can lead to the characteristic [flexikon.doccheck.com]
CONSUMERS: Click here for the Consumer Version Topic Resources Hyperventilation syndrome is anxiety-related dyspnea and tachypnea often accompanied by systemic symptoms. [merckmanuals.com]
Acute hyperventilation with obvious tachypnea accounts for about 1% of all cases of hyperventilation ( Lum 1975 ). [medlink.com]
Acute hyperventilation Patients often present dramatically, with agitation, hyperpnea and tachypnea, chest pain, dyspnea, wheezing, dizziness, palpitations, tetanic cramps (eg, carpopedal spasm), paresthesias, generalized weakness, and syncope. [emedicine.medscape.com]
• Tachypnea differs from hyperpnea in that tachypnea is rapid shallow breaths, while hyperpnea is deep breaths. • In hyperpnoea, the increased breathing rate is desirable as it meets the metabolic needs of the body. • In hyperventilation, the rate of [slideshare.net]
- Hyperpnea
Abstract The hyperventilation syndrome is generally considered an acute, transitory episode characterized by gross hyperpnea and culminating in frank tetany. [annals.org]
Hyperpnea or hyperventilation • Hyperpnea or hyperpnoea is increased depth of breathing when required to meet metabolic demand of body tissues, such as during or following exercise, or when the body lacks oxygen (hypoxia), for instance in high altitude [slideshare.net]
Acute hyperventilation Patients often present dramatically, with agitation, hyperpnea and tachypnea, chest pain, dyspnea, wheezing, dizziness, palpitations, tetanic cramps (eg, carpopedal spasm), paresthesias, generalized weakness, and syncope. [emedicine.medscape.com]
R29.0 ICD-10-CM Diagnosis Code R29.0 Tetany 2016 2017 2018 2019 Billable/Specific Code Applicable To Carpopedal spasm Type 1 Excludes hysterical tetany ( F44.5 ) neonatal tetany ( P71.3 ) parathyroid tetany ( E20.9 ) post-thyroidectomy tetany ( E89.2 ) hyperpnea [icd10data.com]
- Stridor
Harsh, high-pitched inspiratory sounds are characteristic of: stridor. A 30-year-old male presents with acute shortness of breath, widespread hives, and facial swelling. He denies any past medical history and takes no medications. [quizlet.com]
Gastrointestinal
- Nausea
ACUTE ATTACK - agitation, rapid upper chest breathing and heart-rate, chest pains, shortness of breath, nausea, tingling dizziness, clammy hands, dilated pupils, perhaps fainting and general weakness. [familydoctor.co.nz]
Nausea or vomiting. Pain, pressure, or a strange feeling in the back, neck, jaw, or upper belly, or in one or both shoulders or arms. Lightheadedness or sudden weakness. A fast or irregular heartbeat. [peacehealth.org]
Cardiovascular
- Tachycardia
[…] temperature, lung disease–pneumo/hemothorax, pneumonia, pulmonary edema, PE, aspiration, interstitial lung disease, etc–sepsis, liver failure, mechanical ventilation, heat exhaustion, recovery from metabolic acidosis DiffDx Asthma, A Fib, flutter and tachycardia [medical-dictionary.thefreedictionary.com]
Signs and Symptoms OF XANAX addicted • Blurred or double vision • Slurred speech • Headaches • Drowsiness • Heart palpitations • Jaundice • Tachycardia • Tremors Seizures 60. [slideshare.net]
Ears
- Tinnitus
Tinnitus. Palpitations. Feeling of choking or suffocation. Wheezing. Sweating. Loss of consciousness (uncommon). [patient.info]
Musculoskeletal
- Carpopedal Spasm
The diagnosis of HVS should be considered in young patients without cardiac risk factors who present with chest pain, particularly if the pain is associated with paresthesias and carpopedal spasm. [emedicine.medscape.com]
Hyperventilation syndrome related to anxiety can cause alkalosis severe enough to cause carpopedal spasm. A mild fairly well compensated respiratory alkalosis is the usual finding in pregnancy. [anaesthesiamcq.com]
Carpopedal spasm occurs when acute hypocarbia causes reduced ionized calcium and phosphate levels, resulting in involuntary contraction of the feet or (more commonly) the hands. 25. [slideshare.net]
Before neuraxial analgesia had been established, however, and after a period of hyperventilation, the patient was found lying supine with both arms and legs extended, and both wrists in extreme flexion (carpopedal spasm), looking upwards and breathing [academic.oup.com]
spasm Type 1 Excludes hysterical tetany ( F44.5 ) neonatal tetany ( P71.3 ) parathyroid tetany ( E20.9 ) post-thyroidectomy tetany ( E89.2 ) hyperpnea R06.4 hyperventilation R06.4 - see also Hyperventilation ICD-10-CM Codes Adjacent To R06.4 R06 Abnormalities [icd10data.com]
- Muscle Twitch
Acute secondary hypocalcemia can result in carpopedal spasm, muscle twitching, a prolonged QT interval, and positive Chvostek and Trousseau signs. Hypokalemia tends to be less pronounced than hypocalcemia but can produce generalized weakness. [emedicine.medscape.com]
twitching and cramps, tension and panicky feelings, depression and anxiety. [familydoctor.co.nz]
Overbreathing can cause the calcium levels to drop in your blood, which may result in the following nervous system symptoms like numbness and tingling (usually in both arms or around the mouth), spasms or cramps of the hands and feet, and muscle twitching [emedicinehealth.com]
Muscle twitching, spasms, and weakness may be noted. Seizures, irregular heart beats, and tetany (muscle spasms so severe that the muscle locks in a rigid position) can result from severe respiratory alkalosis. [medical-dictionary.thefreedictionary.com]
• Acute secondary hypocalcemia can result in carpopedal spasm, muscle twitching, a prolonged QT interval, and positive Chvostek and Trousseau signs. • Hypokalemia tends to be less pronounced than hypocalcemia but can produce generalized weakness. • [slideshare.net]
- Chvostek Sign
Chvostek's sign is also due to hypocalcaemia. Flick behind the ear, just in front of the mastoid bone where the facial nerve emerges. The hypersensitive facial nerve makes the muscles of the face twitch. [patient.info]
[…] cuff. 30. • Chvostek’s sign is neither sensitive nor specific for hypocalcemia, since it is absent in about one third of patients with hypocalcemia and is present in approximately 10% of persons with normal calcium levels. • Trousseau’s sign is more [slideshare.net]
- Leg Cramp
Cramps: - How to get rid of cramps : How to get rid of cramps breathing exercise - Leg cramps at night : Two easy solutions (Earthing and reduced breathing exercise). [normalbreathing.com]
Urogenital
- Kidney Failure
Risk of Treatment Treatment Risk Intubation, normocarbic ventilation Coughing, ventilator asynchrony, VAP Increased Sedation Hypotension Ventricular CSF drainage Infection Hyperoosmolar therapy Negative fluid balance, hypernatremia, kidney failure Induced [slideshare.net]
Neurologic
- Dizziness
Overview Hyperventilation syndrome is one of the most common causes of dizziness and paresthesias presenting to neurologists, and yet, it is underdiagnosed. [medlink.com]
Most commonly, the history is one of sudden onset of dyspnea, chest pain, or neurologic symptoms (eg, dizziness, weakness, paresthesias, or near-syncope) after a stressful event. [emedicine.medscape.com]
The symptoms typically associated with chronic HVS include faintness, dizziness, and visual disturbances. Chronic HVS is due to exaggerated upper thoracic movement as the diaphragm is not engaged. [ndhealthfacts.org]
Presenting complaints were dyspnea (61%), paresthesia (35%), chest pain or tightness (43%), muscle spasm (9%), dizziness (13%), palpitations (13%), and panic (30%). Similar previous episodes were reported in 74%. [ncbi.nlm.nih.gov]
- Agitation
Patients with acute hyperventilation syndrome (HVS) may present with agitation and anxiety. [emedicine.medscape.com]
Symptoms of Acute HVS are often more dramatic than Chronic HVS and may include breathlessness or the inability to catch one’s breath, agitation, rapid and/or deep breathing, chest pain, dizziness, heart palpitations and loss of consciousness. [ndhealthfacts.org]
It is accompanied by agitation and a sense of terror or by symptoms of chest pain, paresthesias (peripheral and perioral), peripheral tetany (eg, stiffness of fingers or arms), and presyncope or syncope or sometimes by a combination of all of these findings [merckmanuals.com]
The Telangana agitation has the city in hyperventilation mode. What’s hurting badly is Brand Hyderabad. [openthemagazine.com]
The person with ARDS may initially appear agitated as a result of breathing difficulty (rapid breathing or shortness of breath), but later may become lethargic and or even comatose. [rarediseases.org]
- Giddiness
Symptoms of Acute Hyperventilation Acute hyperventilation, during an anxiety attack, causes: Giddiness Gasping Pins-and-needles in the fingers. Symptoms of Chronic Hyperventilation Diagnosis of Chronic hyperventilation is more difficult. [tanvirreza.com]
Headache, giddiness, disturbed sleep, and dizziness were "all indicative of disturbed circulation in the cerebro-spinal centres." Da Costa reasoned that "the heart has become irritable, from its over-action and frequent excitement...." [medlink.com]
• These cycles regulate the amount of oxygen you take in so that you do not experience the fainting, tingling, and giddy sensations that are sometimes associated with overbreathing. 48. [slideshare.net]
Workup
Approach Considerations • Patients with a history of HVS who have undergone an appropriate workup at some earlier time may not need any further laboratory evaluation in the setting of a recurrence. [slideshare.net]
Serum
- Hypocapnia
Abstract Acute hypocapnia decreases CBF, increases hemoglobin affinity for oxygen and causes cerebral tissue hypoxia. This tissue hypoxia is reversed with inhalation of 100% O2 in dogs. [ncbi.nlm.nih.gov]
Symptoms of hypocapnia due to the (pre-)intervention as well as any adverse events will be reported and analysed. [clinicaltrials.gov]
The reduction in MCA V_ was elicited by voluntary hyperventilation induced-hypocapnia. [ci.nii.ac.jp]
In reality, they have about the same oxygenation in the arterial blood (normal values are about 98% for hemoglobin saturation) and too little carbon dioxide ( hypocapnia ) in their blood and other tissues. [en.wikipedia.org]
The U-B PCO2 decreased from a control of 22+/-1 mm Hg (mean+/-SEM) to 11+/-2 mm Hg (mean+/-SEM) with hypocapnia, and rose again to its control value when the blood PCO2 returned to prehyperventilation values. [jci.org]
Treatment
Treatment Group 1 (TG1, n=36) : Mean Age=28yr; Gender: Male=27, Female=9; Mean GCS=5.6. Treatment Group 2 (TG2, n=36) : Mean Age=34yr; Gender: Male=22, Female=14; Mean GCS=5.6. [abiebr.com]
Both treatment programs were equally effective in reducing symptoms, said Meuret. But CART was the only treatment to physiologically alter panic symptoms by actively reversing hyperventilation in the patients. [sciencedaily.com]
Treatment for hyperventilation depends on the cause. Home treatment is usually all that is needed for mild hyperventilation symptoms. [peacehealth.org]
Prognosis
Prognosis Prognosis is generally good but will depend on the underlying cause and comorbidity. [ 12 ] Management of associated disorders (such as agoraphobia) will alter the course of the hyperventilation. [patient.info]
Pneumothorax (Symptoms, Causes, Types, and Prognosis) A pneumothorax is free air in the chest outside the lung, that causes the lung to collapse (collapsed lung). There are two types... [medicinenet.com]
Without the complete withdrawal of medication on long term, a definite healing is impossible Nevertheless that the patient has the subjective feeling of despair about the possibility of healing, the prognosis with the right treatment is good. [15minutes4me.com]
Severe prognosis in a large family with hypokalemic periodic paralysis. Muscle Nerve 2003 ; 27 : 165 –9 8 Geffner I, Murgatroyd J. Tetany. A case induced by hysterical hyperventilation. Br Dent J 1980 ; 148 : 264 9 Day JW, Parry GJ. [academic.oup.com]
Hyperventilation Prognosis With appropriate training, a person may use stress -reduction techniques, breathing exercises, and certain medications to reduce the number and severity of the hyperventilation attacks. [emedicinehealth.com]
Etiology
Because of its bizarre manifestations and its basic etiology, it is seen by everyone regardless of the limitation of one's practice. Too many of us have been lulled into a sense of false security by medical school teachings. [aafp.org]
Practically all categories in the chapter could be designated 'not otherwise specified', 'unknown etiology' or 'transient'. [icd10data.com]
The patient benefits from explanations of laboratory tests and treatment. respiratory alkalosis Metabolism A condition characterized by ↑ pH due to excess CO 2 excretion Etiology Hyperventilation–eg, due to anxiety, pain, panic attacks, psychosis, CVA [medical-dictionary.thefreedictionary.com]
Etiology • Proprioceptors in the lung and chest wall signal the brain with a “suffocation alarm” that triggers release of excitatory neurotransmitters that are responsible for many of the symptoms such as palpitations, tremor, anxiety, and diaphoresis [slideshare.net]
Epidemiology
Maike Pincus, Thomas Keil, Andreas Reich, Ulrich Wahn, Susanne Lau, Linus Grabenhenrich ORAL ABSTRACT SESSION 3: Epidemiology—genetics (OP13–OP18) OP13 Lifestyle is associated with incidence and category of allergen sensitisation: the ALADDIN birth cohort [ncbi.nlm.nih.gov]
Epidemiology It is quite common but precise prevalence is unknown. [patient.info]
Epidemiology • As many as 10% of patients in a general internal medicine practice are reported to have HVS as their primary diagnosis. • The peak incidence is between the ages of 15 and 55 years, but cases have been reported in all age groups except infants [slideshare.net]
Pathophysiology
[…] from Greek: ὑπέρ ("iper") - over and Latin: ventilare - breathe German : Hyperventilation Contents 1 Definition 2 Forms 3 Pathophysiology 4 Symptoms 5 Therapy 1 Definition Hyperventilation is defined as unphysiological deeper and/or faster breathing that [flexikon.doccheck.com]
PATHOPHYSIOLOGY 3. Normal ICP in healthy adult 5-15 mmHg. ICP >20 mmHg accepted as Intracranial Hypertension Figure: Idealized intracranial pressure volume relationships. From: Shapiro, H.M. [slideshare.net]
Lewis contended that acute and chronic hyperventilation syndrome occurred frequently and described the common and atypical presentations, pathophysiology, and therapy ( Lewis 1953 ). [medlink.com]
The pathophysiology of hyperventilation disorders. Chest 1996 ; 109 : 516 –34 3 Contreras G, Gutierrez M, Beroiza T, et al. Ventilatory drive and respiratory muscle function in pregnancy. Am Rev Respir Dis 1991 ; 144 : 837 –41 4 Moore EW. [academic.oup.com]
Nasal congestion, rhinitis, and related conditions: - Nasal congestion : Its causes, mechanism, and treatment - Sinusitis : Causes, pathophysiology, and treatment - How to get rid of a stuffy nose : a very easy breathing exercise - Runny nose : Causes [normalbreathing.com]
Prevention
This means that if you can stop hyperventilating, you can potentially reduce the severity of your panic attacks and perhaps prevent them altogether. [calmclinic.com]
The book is arranged in eight sections concentrating on topics such as prevention of emergencies through patient evaluation (medical history) and specific types of more common emergencies that practitioners may encounter. [books.google.com]
Examples of medications for hyperventilation include: alprazolam (Xanax) doxepin paroxetine (Paxil) You can learn breathing and relaxation techniques to help prevent hyperventilation. [healthline.com]
You, your friends, and family can learn techniques to stop it from happening and prevent future attacks. If you start hyperventilating, the goal is to raise the carbon dioxide level in your blood. This will end most of your symptoms. [medlineplus.gov]
Prevention of parturient paresis by a low-calcium diet prepartum: a field study. J Dairy Sci 1975 ; 58 : 430 –1 6 Lesser, RP. Psychogenic seizures. Neurology 1996 ; 46 : 1499 –507 7 Caciotti A, Morrone A, Domenici R, Donati MA, Zammarchi E. [academic.oup.com]